Active NPI
Elizabeth R. McKoy, FNP
- Family Nurse Practitioner
- Stockton, CA
National Provider Identifier
1982825063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 15595
- Practice address
- 3601 Pacific Ave
Stockton, CA 95211-0110 - Phone
- (209) 946-2315
- Fax
- (209) 946-3001
- NPI assigned
- May 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 15595 | CA | Primary |
Addresses
Primary practice location
3601 Pacific Ave
Stockton, CA 95211-0110
Mailing address
3601 Pacific Ave
Stockton, CA 95211-0110
Phone (209) 946-2315
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434067200000",
"number": "1982825063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3601 PACIFIC AVE",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952110110",
"telephone_number": "209-946-2315",
"fax_number": "209-946-3001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 PACIFIC AVE",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952110110",
"telephone_number": "209-946-2315",
"fax_number": "209-946-3001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKOY",
"first_name": "ELIZABETH",
"middle_name": "R.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-02",
"last_updated": "2015-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "15595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.